How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $2,137.96 | Facility | None | $1.12 | $1.12 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.02 Median $0.04 Typical High $0.59 | Facility | None | $0.02 | $0.04 | $0.59 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.03 Median $0.05 Typical High $0.31 | Professional | None | $0.03 | $0.05 | $0.31 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.02 Median $0.02 Typical High $0.22 | Professional | 78 · Unplanned return to OR | $0.02 | $0.02 | $0.22 |
Cigna Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.05 | Facility | None | $0.02 | $0.02 | $0.05 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Moda Health Setting Facility Modifier None Typical Low $0.02 Median $0.41 Typical High $9.55 | Facility | None | $0.02 | $0.41 | $9.55 |
Moda Health Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.34 Median $0.38 Typical High $0.55 | Facility | None | $0.34 | $0.38 | $0.55 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.34 Median $0.38 Typical High $0.65 | Professional | None | $0.34 | $0.38 | $0.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 78 · Unplanned return to OR | $0.23 | $0.23 | $0.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | None | $0.05 | $0.05 | $0.06 |
Select Health Setting Facility Modifier None Typical Low $0.04 Median $0.05 Typical High $0.06 | Facility | None | $0.04 | $0.05 | $0.06 |
Select Health Setting Professional Modifier None Typical Low $0.03 Median $0.31 Typical High $0.31 | Professional | None | $0.03 | $0.31 | $0.31 |
United Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Professional Modifier 22 · Increased work Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 22 · Increased work | $0.34 | $0.34 | $0.34 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 54 · Surgery only | $0.22 | $0.22 | $0.22 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
MountainHealth Co-op Setting Professional Modifier 63 · Small infant Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 63 · Small infant | $0.34 | $0.34 | $0.34 |
Where Idaho sits
The same service costs 26.3 times more in Montana than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 6th of 51
$0.03
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.